Provider Demographics
NPI:1114552841
Name:JOURNEY TO AWARENESS COUNSELING, LLC
Entity Type:Organization
Organization Name:JOURNEY TO AWARENESS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-908-0944
Mailing Address - Street 1:117 BOCAGE DR
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-3037
Mailing Address - Country:US
Mailing Address - Phone:504-908-0944
Mailing Address - Fax:
Practice Address - Street 1:4266 W MAIN ST STE 109
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:LA
Practice Address - Zip Code:70359-6421
Practice Address - Country:US
Practice Address - Phone:504-908-0944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-03
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health